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Many EDs Do Not Have Pediatric Area, Emergency Care Coordinator

FRIDAY, Dec. 28, 2018 -- Many emergency departments do not have a pediatric area or pediatric emergency care coordinator (PECC), but an intervention can increase use of PECCs, according to three studies published in the December issue of Academic Emergency Medicine.

Alexandra Camargo, from Massachusetts General Hospital in Boston, and colleagues surveyed all 5,273 U.S. emergency departments to characterize emergency care in 2015. The researchers found that 10 percent of general emergency departments reported having a pediatric area and 16 percent of all U.S. emergency departments reported having a PECC. A pediatric area was more likely for emergency departments with larger visit volumes and those in the Northeast or South. Seventy-five percent of general emergency departments with a pediatric area had a PECC.

Monica Brova, M.P.H., from the Boston University School of Public Health, and colleagues surveyed 130 of the 337 emergency departments that reported receiving pediatric telemedicine. Of the 107 emergency departments completing the survey, 90 and 83 percent confirmed use in 2016 and 2017, respectively. Technical reasons and scheduling concerns were reasons reported for discontinuation. The most frequently reported challenges were process concerns and technological concerns (30 and 14 percent, respectively). In a third study, Carlos A. Camargo Jr., M.D., from Harvard Medical School in Boston, and colleagues surveyed 73 Massachusetts emergency departments annually from 2014 to 2018. A grassroots intervention was implemented to establish a PECC in every Massachusetts emergency department. The researchers identified an increase in the percentage of emergency departments with an appointed PECC over time, from about 30 percent in 2014 to 2016 to 85 and 100 percent in 2017 and 2018, respectively.

"We believe an intervention like this one could have similar results elsewhere, and we have started to replicate the project in a few volunteer states," Camargo said in a statement.

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Posted: December 2018

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